ORIGINAL RESEARCH article
Front. Psychol.
Sec. Educational Psychology
Enhancing Peer Teaching and Psychological Outcomes in Medical Education through Structured Formative Assessment: A Quasi-Experimental Study
Provisionally accepted
Dawei Zhang1Kuibo Zhang1Junquan Chen1Binfang Shang1Zhongzhen Su1Qiang Wu2Lianjun Yang1Lili Xie1
Hai Lv1*- 1Department of Infectious Disease Intensive Care Unit, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
- 2Shaoguan First People's Hospital, Shaoguan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Peer-assisted learning (PAL) is an established approach in medical education, yet variability in teaching quality persists when peer tutors lack structured pedagogical support. This study examined whether integrating a structured formative assessment framework could enhance peer tutors’ teaching performance, teaching self-efficacy, and reduce teaching anxiety, as well as improve first-year students’ knowledge, academic motivation, and self-efficacy. Methods: A quasi-experimental, parallel- group study was conducted in three medical universities in Guangdong, China (2024–2025). Final-year medical students (n = 122) served as peer tutors and were allocated to an intervention (n = 61) or control groups (n = 61), each supervising 6–8 first-year students (total first-year students initially = 850; final analytic sample = 820 (intervention n = 411; control n = 409). The intervention integrated validated formative assessment tools—Mini- Clinical Evaluation Exercise (Mini-CEX), Direct Observation of Procedural Skills (DOPS), and Reflective Teaching Journals—alongside faculty feedback and self-reflection. Data were analyzed using linear mixed-effects models (LMM) accounting for student–tutor nesting. False discovery rate (FDR) correction was applied to control for multiple testing. Results: Significant group × time interactions favored the intervention group across all outcomes. Students taught by intervention-group tutors showed higher post-test knowledge (7.93 ± 0.31 vs. 5.28 ± 1.10; F = 54.9, p < 0.001, η² = 0.18) and greater academic motivation and self-efficacy (both p < 0.001). Peer tutors demonstrated higher teaching self-efficacy (72.48 ± 5.73 vs. 69.13 ± 5.91; F = 22.3, p < 0.001, η² = 0.15) and lower teaching anxiety (2.34 ± 0.33 vs. 2.65 ± 0.39; F = 17.1, p < 0.001, η² = 0.14). Post-test performance measures (PES-TBL, Mini-CEX, DOPS) were consistently higher in the intervention group (all p < 0.001). Qualitative reflections revealed challenges in communication and confidence but documented progressive improvements in interaction and teaching clarity. Conclusions: This study provides preliminary evidence that integrating structured formative assessment into peer-assisted learning enhances tutors’ instructional competence, strengthens self-efficacy, and reduces teaching anxiety, while simultaneously improving students’ motivation and learning outcomes. Embedding formative assessment within PAL may represent a feasible and scalable strategy to improve teaching quality in medical education
Keywords: Peer-Assisted Learning1, Formative Assessment2, Teaching Self-Efficacy3, TeachingAnxiety4, Academic Motivation5, Medical Education6
Received: 23 Sep 2025; Accepted: 25 Nov 2025.
Copyright: © 2025 Zhang, Zhang, Chen, Shang, Su, Wu, Yang, Xie and Lv. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hai Lv
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.